Location: Dreiser Community Center, Community Center Room 4, 177 Dreiser Loop, Bronx, NY 10475
When: Tuesday, April 16, 2024 at 6:30PM

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* 1. First Name

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* 2. Last Name

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* 3. Email Address

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* 4. Phone Number

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* 5. Home Address

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* 6. County of Residence

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* 7. Do you require reasonable accommodations? 
*Please allow at least 14 days to allow seamless implementation of your request.

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* 8. If you have a disability and require accommodations not mentioned above in order to fully participate in this training, describe your requirements here. Please allow at least 14 days to allow seamless implementation of your request. If you have questions please email: NY.Prepare@dhses.ny.gov

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